Saturday, September 05, 2009

Role of microdebriders in nasal endoscopic sinus surgery

History: Microdebrider surgical technique was first introduced by Urban in 1968 for removing large acoustic neuromas. This instrument became a fancied tool for orthopedic surgeons who specialised in joint surgeries. Later on plastic surgeons started using this technique for performing liposuction procedures. Otolaryngologists did not lag behind in adapting this equipment for nasal surgeries.

Components of microdebrider:
A debrider contains three components.

1. The console which helps in controlling the speed of rotation/direction of rotation. These parameters can easily be changed with the help of a attached foot pedal.
2. The blade: This is a tubular metal structure with serrated edge / smooth edge. The cutting edge is present only on one side only, while the smooth opposite surface does not cut. It is usually connected to a suction tube. These blades come in various sizes and configurations. This blade allows for simultaneous cutting and removal of cut tissue by suction.
3. Handpiece: Which is a portable micromotor. It derives its power supply from the console. The blade is attached to the shaft of the hand piece.

Advantages of microdebrider:
1. It cuts and removes tissue
2. Suction applied holds the tissue to the blade facilitating their cutting
3. Microdebrider is useful in performing polypectomy surgeries in the nose. It causes minimal trauma to normal turbinate tissue. Since it cuts on one side only, the opposite side is not traumatized. Since there is no raw area on the opposite side the incidence of post op synechiae formation is minimized.

Image showing the console
You can see a video of debrider in action:

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